About Me

Allison is a registered nurse and senior health policy adviser with some 25 years experience. Prior to launching CPD Nurse Escapes, Allison worked as a private consultant for a diverse range of clients in the government and non-government, health, community and education sectors. Allison has an extensive background in regulation, governance and professional practice and applies this in education, policy development and project management. Allison was the Principal Advisor, Professional Practice at the Nursing & Midwifery Board of South Australia, for 10 years where she was responsible for developing nursing and midwifery policy and standards and advising and educating nurses and midwives on professional practice issues.

Saturday, 17 September 2011

Understanding Accountability (ENs Part 3)

Accountability

All nurses are answerable for her/his decisions, actions and behaviours and for the consequences of those decisions, actions and behaviours.

All nurses are accountable for all decisions, actions and delegation decisions, the accountability for which cannot be delegated. Professional accountability requires that the nurse considers and weighs up the interests of the client in complex, changing situations, using professional knowledge, skills and judgement to make a decision enabling them to account for their actions.

All nurses are answerable for her/his own decisions, actions and behaviours and for the consequences of these decisions, actions and behaviours. This accountability is not delegable transferable/rescindable.

All nurses are accountable to the;

·client

·supervisor/manager

·employer

·regulator

·profession

·public

In meeting their accountability a nurse must be prepared to answer to others, such as health care consumers, regulatory authority, employers/public for their decisions, actions, behaviours and the responsibilities that are inherent in their roles which cannot be delegated

The registered nurse who delegates is accountable, not only for their delegation decision but also for monitoring the standard of performance of the activity by the other person, and for evaluating the outcomes of the delegation

The Registered Nurse is accountable for:

·autonomous decision-making within their own scope of practice

·their own decisions and actions (including the decision to delegate)

·the consequences and outcomes of their decisions and actions

·supervision of the enrolled nurse

·delegation to the enrolled nurse

The Enrolled Nurse is accountable for:

·practicing
under the supervision of a registered nurse within their own scope of practice

·their own decisions and actions (including
the decision to accept delegation)

·the consequences of their decisions and
actions

This is a pro-active and professional relationship with equal
accountability for the maintenance of the professional relationship and for
determining appropriate supervision and delegation.

Enrolled
nurses (however called) practice under the supervision (direct or indirect) of
a registered nurse. The enrolled nurse retains responsibility for their actions
and remains accountable to the registered nurse for all delegated decisions and
functions. However they are equally responsible for making clear decisions
within their scope of practice and are accountable for these decisions and
their practice.

All
nurses accepting delegation must have an understanding of their professional
competence and not accept delegated functions that are beyond their preparation
and competence.

Therefore

No nurse (registered or enrolled) may be
directed, pressured or compelled by an employer, or any other person in a
position of authority

·to delegate (or accept delegated)
care that the nurse determines in their professional judgement is inappropriate

·to engage in
any practice that falls short of, or is in breach of any professional standard
and/or code of conduct or practice

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